Cited by 752Bone health and osteoporosis researchMenopause: Health Impacts and TreatmentsBone health and treatments

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Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs

Cummings, Steven R., Karpf, David B., Harris, Fran, Genant, Harry K., Ensrud, Kristine, LaCroix, Andrea Z., Black, Dennis M.·2002·The American Journal of Medicine

DOI 10.1016/s0002-9343(01)01124-x

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Abstract

Purpose To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis.Methods After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density.Results Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate.Conclusion Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

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Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures
Black, D. M., Cummings, S. R., Karpf, D. B., Cauley, J. A., Thompson, D. E., Nevitt, M. C., Bauer, D. C., Genant, H. K., Haskell, W. L., Marcus, R., et al. (1996) · The Lancet · doi:10.1016/s0140-6736(96)07088-2 · Cited by 3,846
Self-citation
Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures
Marshall, D., Johnell, O., & Wedel, H. (1996) · BMJ · doi:10.1136/bmj.312.7041.1254 · Cited by 3,709
Reduction of Vertebral Fracture Risk in Postmenopausal Women With Osteoporosis Treated With Raloxifene<SUBTITLE>Results From a 3-Year Randomized Clinical Trial</SUBTITLE>
Ettinger, B. (1999) · JAMA · doi:10.1001/jama.282.7.637 · Cited by 3,366
Effects of Risedronate Treatment on Vertebral and Nonvertebral Fractures in Women With Postmenopausal Osteoporosis<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>
Harris, S. T. (1999) · JAMA · doi:10.1001/jama.282.14.1344 · Cited by 2,475
Effect of Alendronate on Risk of Fracture in Women With Low Bone Density but Without Vertebral Fractures<SUBTITLE>Results From the Fracture Intervention Trial</SUBTITLE>
Cummings, S. R. (1998) · JAMA · doi:10.1001/jama.280.24.2077 · Cited by 2,277
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Effect of Oral Alendronate on Bone Mineral Density and the Incidence of Fractures in Postmenopausal Osteoporosis
Liberman, U. A., Weiss, S. R., Bröll, J., Minne, H. W., Quan, H., Bell, N. H., Rodriguez-Portales, J. A., Downs, R. W., Dequeker, J., Favus, M. J., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199511303332201 · Cited by 2,276
Self-citation
Randomized Trial of the Effects of Risedronate on Vertebral Fractures in Women with Established Postmenopausal Osteoporosis
Reginster, J.-Y., Minne, H. W., Sorensen, O. H., Hooper, M., Roux, C., Brandi, M. L., Lund, B., Ethgen, D., Pack, S., Roumagnac, I., et al. (2000) · Osteoporosis International · doi:10.1007/s001980050010 · Cited by 1,580
A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study
Chesnut, C. H., Silverman, S., Andriano, K., Genant, H., Gimona, A., Harris, S., Kiel, D., LeBoff, M., Maricic, M., Miller, P., et al. (2000) · The American Journal of Medicine · doi:10.1016/s0002-9343(00)00490-3 · Cited by 1,122
Self-citation
Markers of bone resorption predict hip fracture in elderly women: The EPIDOS prospective study
Garnero, P., Hausherr, E., Chapuy, M. C., Marcelli, C., Grandjean, H., Müller, C., Cormier, C., Bréart, G., Meunier, P. J., & Delmas, P. D. (1996) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650111021 · Cited by 984
Intermittent Cyclical Etidronate Treatment of Postmenopausal Osteoporosis
Watts, N. B., Harris, S. T., Genant, H. K., Wasnich, R. D., Miller, P. D., Jackson, R. D., Licata, A. A., Ross, P. D., Woodson, G. C., Yanover, M., et al. (1990) · New England Journal of Medicine · doi:10.1056/nejm199007123230201 · Cited by 947
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Show all 35 references

Research works printed but not linked: 4

Cummings, 1996, Changes in BMD substantially underestimate the anti-fracture effects of alendronate and other antiresorptive drugs, J Bone Miner Res, 11, S102
Genant, 1998, Chronic intermittent cyclical administration of tiludronate in postmenopausal osteoporosis, Bone, 23, S175
Black, 1993, Prediction of new vertebral deformities, J Bone Miner Res, 8, S135
Cann, 1999, PTH effects in the femur, J Bone Miner Res, 14, S137

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Authors: Cummings, S. R., Karpf, D. B., Harris, F., Genant, H. K., Ensrud, K., LaCroix, A. Z., & Black, D. M.
Affiliations: University of California, San Francisco (US)
Geron (United States) (US)
University of Minnesota (US)
University of Washington (US)
Corresponding author: Cummings, Steven R.
ORCID: Cummings, Steven R.
Genant, Harry K.
Ensrud, Kristine
LaCroix, Andrea Z.
Black, Dennis M.
Venue: The American Journal of Medicine
Publisher: Elsevier BV
Published: 2002-03
Volume: 112
Issue: 4
Pages: 281-289
ISSN: 0002-9343 (ISSN-L)
DOI: 10.1016/s0002-9343(01)01124-x
OpenAlex: W2110828193
Cited by: 752
References: 35
Citations by year: 2026: 7 · 2025: 10 · 2024: 17 · 2023: 12 · 2022: 12 · 2021: 16 · 2020: 25 · 2019: 10 · 2018: 11 · 2017: 18 · 2016: 25 · 2015: 19 · 2014: 24 · 2013: 29 · 2012: 43
FWCI: 8.42
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Oncology › Bone health and treatments
Keywords: osteoporosis, vertebral fractures, bone mineral density, antiresorptive agents, alendronate, postmenopausal women, Fracture Intervention Trial, fracture risk reduction, bone mass
MeSH terms: Bone Resorption, Female, Fractures, Spontaneous, Humans, Regression Analysis, Risk Factors, Spine, Bone Density, Osteoporosis, Postmenopausal, Logistic Models, Spinal Fractures, Alendronate

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Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs

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